Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 6301008505 | MI |
N | 104100000X | Social Worker | 6802009067 | MI |
NPI | 1235575077 |
---|---|
Provider Name | Mrs. Sandra L Tropp |
First Address | Jackson, MI 49202-2005 |
Second Address | Jackson, MI 49202-2005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2013 |
Last Update Date | 20/05/2013 |